Provider Demographics
NPI:1407874332
Name:WINCHELL, CHERYL TAPP (DO)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:TAPP
Last Name:WINCHELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:CHERYL
Other - Middle Name:REBECCA
Other - Last Name:TAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1627 US HIGHWAY 1
Mailing Address - Street 2:STE 101
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3899
Mailing Address - Country:US
Mailing Address - Phone:772-581-9551
Mailing Address - Fax:772-581-9646
Practice Address - Street 1:1627 US HIGHWAY 1
Practice Address - Street 2:STE 101
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3899
Practice Address - Country:US
Practice Address - Phone:772-581-9551
Practice Address - Fax:772-581-9646
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7769207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH13031Medicare UPIN
FL49871UMedicare PIN
FL49871Medicare UPIN